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COMPARATIVE STUDY OF THE KNOWLEDGE AND ATTITUDE TOWARDS HEPATITIS B VIRUS INFECTION AND ITS SEROPREVALENCE AMONG WASTE SCAVENGERS AND MARKET PORTERS IN LAGOS STATE
Abstract
Introduction: The blood-borne viruses infect hundreds of millions of people worldwide and their continuous spread depends on practices that involve contact with blood or other body fluids. Waste scavengers are those individuals who informally recover items from waste for the purpose of reuse or recycling. These waste scavengers, who most often operate without any protective measures, are exposed to a wide range of health risks such as blood borne infections (due to handling of hospital waste). Studies from developed countries have shown that occupational exposure to waste may result in hepatitis B virus (HBV) infection. HBV infection is one of the major diseases that cause serious public health problems. Globally over 2 billion people are infected with hepatitis B virus, of which more than 350 million have chronic HBV infection. It has been estimated that annually about 1.2 million people die globally from chronic HBV infection, cirrhosis and liver cancer. There is a dearth of information on the prevalence of HBV infection among waste scavengers in Lagos, Nigeria.
Objective: The aim of the study was to compare the knowledge of and attitude towards hepatitis B virus infection and its seroprevalence among waste scavengers and market porters in Lagos State.
Materials and Methods: The study was a comparative cross-sectional study. A multistage sampling technique was used to select 136 waste scavengers while 131 market porters were recruited from their clusters found within the market. Quantitative data was collected using a pre-tested, semi-structured, interviewer-administered questionnaire to obtain information on socio-demographic characteristics, occupational history, knowledge of and attitude towards HBV infection and presence of risk factors for HBV infection among the respondents. HBV seroprevalence was determined using Hepatitis B Surface Antigen Rapid Test Strip (Abon Biopharm (Hangzhou) Co. Ltd. P.R. China). Data was analysed with SPSS (Statistical Package for Social Sciences) version 17.
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Results: Majority of the waste scavengers (50.4%) and market porters (41.5%) had poor knowledge on HBV infection. More market porters (34.4%) had good knowledge than the waste scavengers (26.8%). These differences in their level of knowledge were not statistically significant. Majority (92.1%) of the waste scavengers had positive attitude towards HBV infection as compared with the market porters (73.6%). This difference was statistically significant (P<0.05). The seroprevalence of HBV infection was higher among the waste scavengers (17.6%) than among the market porters (5.3%). The difference in the seroprevalence of HBV infection among the two groups was statistically significant (P<0.05). There was no association between the ages of the respondents, their level of education and their knowledge and attitude towards HBV infection. Waste scavenging as an occupation, was the only risk factor that was statistically significantly associated with higher HBV seroprevalence in the waste scavengers. The waste scavengers were 3.59 times (C.I 1.09 – 11.82) as likely to be positive for HBV infection as the markets porters. This odd ratio was statistically significant (P<0.05).
Conclusions: The waste scavengers were more at risk of contacting HBV infection through medical waste on the dumpsite than the market porters whose occupation do not involve contact with waste. There is a need for the provision of health education materials on the risk associated with exposure to medical waste as potential source of HBV infection while scavenging on the dumpsites and the need for regular and correct use of appropriate personal protective equipment (PPE). Modalities for immunization of waste scavengers who are negative for HBV after screening and anyone who intends to take up waste scavenging as an occupation should be in place. Medical facilities and individuals are advised to use the medical waste disposal service provided by Lagos Waste Management Authority (LAWMA).
